Growth and micronutrient status parameters of Nigerian preterm infants consuming preterm formula or breastmilk.
Journal
Pediatric research
ISSN: 1530-0447
Titre abrégé: Pediatr Res
Pays: United States
ID NLM: 0100714
Informations de publication
Date de publication:
09 Jan 2024
09 Jan 2024
Historique:
received:
05
01
2023
accepted:
04
12
2023
revised:
26
11
2023
medline:
10
1
2024
pubmed:
10
1
2024
entrez:
10
1
2024
Statut:
aheadofprint
Résumé
Moderate-to-late preterm infants (32-34 weeks GA) have increased risk of neonatal morbidities compared to term infants, however dedicated nutritional guidelines are lacking. Moderate-to-late preterm infants received a preterm formula (n = 17) or breastmilk (n = 24) from age 2-10 weeks in a non-randomized, open-label observational study. Anthropometric measurements were assessed bi-weekly. Blood concentrations of hemoglobin, ferritin, serum retinol, and 25-hydroxy-vitamin D (25OHD) were analyzed at age 2 and 10 weeks. Average growth per day was 14.7 g/kg BW/day in formula-fed and 12.8 g/kg BW/day in breastmilk-fed infants but not different from each other. Length and head circumference in both groups were in line with the median reference values of the Fenton growth chart. At 10 weeks of age, hemoglobin tended to be higher in the formula-fed group (10.2 g/dL vs. 9.6 g/dL, p = 0.053). 25OHD increased in formula- and breastmilk-fed infants from 73.8 to 180.9 nmol/L and from 70.7 to 97.6 nmol/L, respectively. Serum retinol only increased in the formula-fed group (0.63 to 1.02 µmol/L, p < 0.001). Breastfeeding resulted in adequate growth in moderate-late preterm infants but was limiting in some micronutrients. The preterm formula provided adequate micronutrients, but weight gain velocity was higher than the Fenton reference value. Unfortified breastmilk resulted in adequate growth in weight, length and head circumference in Nigerian moderate to late preterm infants during an study period of 8 weeks, but status of vitamin D, vitamin A and iron needs to be monitored. The high-energy formula, developed for very preterm infants, resulted in higher growth in body weight in moderate to late preterm infants than the median of the Fenton preterm growth chart. This study supports the necessity of dedicated nutritional guidelines, and regular monitoring of growth and nutritional status of moderate to late preterm infants.
Sections du résumé
BACKGROUND
BACKGROUND
Moderate-to-late preterm infants (32-34 weeks GA) have increased risk of neonatal morbidities compared to term infants, however dedicated nutritional guidelines are lacking.
METHODS
METHODS
Moderate-to-late preterm infants received a preterm formula (n = 17) or breastmilk (n = 24) from age 2-10 weeks in a non-randomized, open-label observational study. Anthropometric measurements were assessed bi-weekly. Blood concentrations of hemoglobin, ferritin, serum retinol, and 25-hydroxy-vitamin D (25OHD) were analyzed at age 2 and 10 weeks.
RESULT
RESULTS
Average growth per day was 14.7 g/kg BW/day in formula-fed and 12.8 g/kg BW/day in breastmilk-fed infants but not different from each other. Length and head circumference in both groups were in line with the median reference values of the Fenton growth chart. At 10 weeks of age, hemoglobin tended to be higher in the formula-fed group (10.2 g/dL vs. 9.6 g/dL, p = 0.053). 25OHD increased in formula- and breastmilk-fed infants from 73.8 to 180.9 nmol/L and from 70.7 to 97.6 nmol/L, respectively. Serum retinol only increased in the formula-fed group (0.63 to 1.02 µmol/L, p < 0.001).
CONCLUSION
CONCLUSIONS
Breastfeeding resulted in adequate growth in moderate-late preterm infants but was limiting in some micronutrients. The preterm formula provided adequate micronutrients, but weight gain velocity was higher than the Fenton reference value.
IMPACT STATEMENT
UNASSIGNED
Unfortified breastmilk resulted in adequate growth in weight, length and head circumference in Nigerian moderate to late preterm infants during an study period of 8 weeks, but status of vitamin D, vitamin A and iron needs to be monitored. The high-energy formula, developed for very preterm infants, resulted in higher growth in body weight in moderate to late preterm infants than the median of the Fenton preterm growth chart. This study supports the necessity of dedicated nutritional guidelines, and regular monitoring of growth and nutritional status of moderate to late preterm infants.
Identifiants
pubmed: 38195937
doi: 10.1038/s41390-023-02976-6
pii: 10.1038/s41390-023-02976-6
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s).
Références
Kerstjens, J. M., de Winter, A. F., Bocca-Tjeertes, I. F., Bos, A. F. & Reijneveld, S. A. Risk of developmental delay increases exponentially as gestational age of preterm infants decreases: a cohort study at age 4 years. Dev. Med. Child Neurol. 54, 1096–1101, https://doi.org/10.1111/j.1469-8749.2012.04423.x (2012).
doi: 10.1111/j.1469-8749.2012.04423.x
pubmed: 23020259
Escobar, G. J. et al. Unstudied infants: outcomes of moderately premature infants in the neonatal intensive care unit. Arch. Dis. Child Fetal Neonatal Ed. 91, F238–44, https://doi.org/10.1136/adc.2005.087031 (2006).
doi: 10.1136/adc.2005.087031
pubmed: 16611647
pmcid: 2672722
Brown, A. K. et al. Factors relating to readmission of term and near-term neonates in the first two weeks of life. J. Perinat. Med. 27, 263–275, https://doi.org/10.1515/JPM.1999.037 (1999).
doi: 10.1515/JPM.1999.037
pubmed: 10560077
Tomashek, K. M. et al. Early discharge among late preterm and term newborns and risk of neonatal morbidity. Semin. Perinatol. 30, 61–68, https://doi.org/10.1053/j.semperi.2006.02.003 (2006).
doi: 10.1053/j.semperi.2006.02.003
pubmed: 16731278
Kuzniewicz, M. W. et al. Hospital readmissions and emergency department visits in moderate preterm, late preterm, and early term infants. Clin. Perinatol. 40, 753–775 (2013).
doi: 10.1016/j.clp.2013.07.008
pubmed: 24182960
Nigerian Federal Ministry of Health. National Guidelines for Comprehensive Newborn Care. 1st ed. (Nigerian Federal Ministry of Health, 2021).
Zini, M. E. & Omo-Aghoja, L. O. Clinical and sociodemographic correlates of preterm deliveries in two tertiary hospitals in southern Nigeria. Ghana Med J. 53, 20–28, https://doi.org/10.4314/gmj.v53i1.4 (2019).
doi: 10.4314/gmj.v53i1.4
pubmed: 31138940
pmcid: 6527821
Agostoni, C. et al. Enteral nutrient supply for preterm infants: Commentary from the european society of paediatric gastroenterology, hepatology and nutrition committee on nutrition. J. Pediatr. Gastroenterol. Nutr. 50, 85–91, https://doi.org/10.1097/MPG.0B013E3181ADAEE0 (2010).
doi: 10.1097/MPG.0B013E3181ADAEE0
pubmed: 19881390
Tsang, R., et al. in Nutrition of the Preterm Infant. Scientific Basis and Practical Guidelines. 2nd edn. (eds. Tsang, R. C., Uauy, R., Koletzko, B. & Zlotkin, S.) (Digital Educational Publishing, Inc., 2005).
Fenton, T. R. et al. Validating the weight gain of preterm infants between the reference growth curve of the fetus and the term infant. BMC Pediatr. 13, 92, https://doi.org/10.1186/1471-2431-13-92 (2013).
doi: 10.1186/1471-2431-13-92
Fenton, T. R. A new growth chart for preterm babies: Babson and Benda’s chart updated with recent data and a new format. BMC Pediatr. 3, 13, https://doi.org/10.1186/1471-2431-3-13 (2003).
doi: 10.1186/1471-2431-3-13
pubmed: 14678563
pmcid: 324406
Cheang, H. K. et al. A survey among healthcare professionals from seven countries reported diverse nutritional practices of late preterm infants. Acta Paediatr. 111, 1362–1371, https://doi.org/10.1111/apa.16344 (2022).
doi: 10.1111/apa.16344
pubmed: 35340076
Fenton, T. R. et al. An attempt to standardize the calculation of growth velocity of preterm infants—evaluation of practical bedside methods. J. Pediatr. 196, 77–83, https://doi.org/10.1016/j.jpeds.2017.10.005 (2018).
doi: 10.1016/j.jpeds.2017.10.005
pubmed: 29246464
Lapillonne, A. et al. Feeding the late and moderately preterm infant: a position paper of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J. Pediatr. Gastroenterol. Nutr. 69, 259–270, https://doi.org/10.1097/MPG.0000000000002397 (2019).
doi: 10.1097/MPG.0000000000002397
pubmed: 31095091
Ruys C. A., van de Lagemaat M., Rotteveel J., Finken M. J. J., Lafeber H. N. Improving long-term health outcomes of preterm infants: how to implement the findings of nutritional intervention studies into daily clinical practice. Eur J Pediatr. https://doi.org/10.1007/s00431-021-03950-2 (2021).
Hay, W. W. & Thureen, P. Protein for preterm infants: How much is needed? How much is enough? How much is too much? Pediatr. Neonatol. 51, 198–207, https://doi.org/10.1016/S1875-9572(10)60039-3 (2010).
doi: 10.1016/S1875-9572(10)60039-3
pubmed: 20713283
Hay, W. W. Nutritional support strategies for the preterm infant in the neonatal intensive care unit. Pediatr. Gastroenterol. Hepatol. Nutr. 21, 234–247, https://doi.org/10.5223/pghn.2018.21.4.234 (2018).
doi: 10.5223/pghn.2018.21.4.234
pubmed: 30345236
pmcid: 6182475
Amesz, E. M., Schaafsma, A., Cranendonk, A. & Lafeber, H. N. Optimal growth and lower fat mass in preterm infants fed a protein-enriched postdischarge formula. J. Pediatr. Gastroenterol. Nutr. 50, 200–207 (2010).
doi: 10.1097/MPG.0b013e3181a8150d
pubmed: 19881394
Pawley, N. & Bishop, N. J. Prenatal and infant predictors of bone health: the influence of vitamin D. Am. J. Clin. Nutr. 80, 1748–1751, https://doi.org/10.1093/ajcn/80.6.1748s (2004).
doi: 10.1093/ajcn/80.6.1748s
Salle, B. L., Delvin, E. E., Lapillonne, A., Bishop, N. J. & Glorieux, F. H. Perinatal metabolism of vitamin D. Am. J. Clin. Nutr. 71, 1317S–24S, https://doi.org/10.1093/ajcn/71.5.1317s (2000).
doi: 10.1093/ajcn/71.5.1317s
pubmed: 10799409
Stoutjesdijk, E. et al. Milk Vitamin D in relation to the ‘adequate intake’ for 0-6-month-old infants: a study in lactating women with different cultural backgrounds, living at different latitudes. Br. J. Nutr. 118, 804–812, https://doi.org/10.1017/S000711451700277X (2017).
doi: 10.1017/S000711451700277X
pubmed: 29103383
Friel, J., Qasem, W. & Cai, C. Iron and the breastfed infant. Antioxidants 7, 2–9, https://doi.org/10.3390/antiox7040054 (2018).
doi: 10.3390/antiox7040054
Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc (The National Academies Press; 2001). https://doi.org/10.17226/10026 .
Dirks, N. F. et al. Various calibration procedures result in optimal standardization of routinely used 25(OH)D ID-LC-MS/MS methods. Clin. Chim. Acta 462, 49–54, https://doi.org/10.1016/j.cca.2016.08.016 (2016).
doi: 10.1016/j.cca.2016.08.016
pubmed: 27570062
pmcid: 5703036
Bischoff-Ferrari, H. The 25-hydroxyvitamin D threshold for better health. J. Steroid Biochem. Mol. Biol. 103, 614–619, https://doi.org/10.1016/j.jsbmb.2006.12.016 (2007).
doi: 10.1016/j.jsbmb.2006.12.016
pubmed: 17227709
Bouillon, R. & Carmeliet, G. Vitamin D insufficiency: definition, diagnosis and management. Best. Pr. Res Clin. Endocrinol. Metab. 32, 669–684, https://doi.org/10.1016/j.beem.2018.09.014 (2018).
doi: 10.1016/j.beem.2018.09.014
Mailhot, G. & White, J. H. Vitamin D and immunity in infants and children. Nutrients 12, 1233, https://doi.org/10.3390/nu12051233 (2020).
doi: 10.3390/nu12051233
pubmed: 32349265
pmcid: 7282029
Miller, K. W. & Yang, C. S. An isocratic high-performance liquid chromatography method for the simultaneous analysis of plasma retinol, α-tocopherol, and various carotenoids. Anal. Biochem. 145, 21–26, https://doi.org/10.1016/0003-2697(85)90321-5 (1985).
doi: 10.1016/0003-2697(85)90321-5
pubmed: 4003760
Murguía-Peniche, T. Vitamin D, vitamin A, maternal-perinatal considerations: old concepts, new insights, new questions. J. Pediatr. 162, 26–30, https://doi.org/10.1016/j.jpeds.2012.11.050 (2013).
doi: 10.1016/j.jpeds.2012.11.050
Amin, S. B., Scholer, L. & Srivastava, M. Pre-discharge iron status and its determinants in premature infants. J. Matern Fetal Neonatal Med. 25, 2265–2269, https://doi.org/10.3109/14767058.2012.685788 (2012).
doi: 10.3109/14767058.2012.685788
pubmed: 22734563
Strauss, R. G. Anaemia of prematurity: pathophysiology and treatment. Blood Rev. 24, 221–225, https://doi.org/10.1016/j.blre.2010.08.001 (2010).
doi: 10.1016/j.blre.2010.08.001
pubmed: 20817366
pmcid: 2981681
Khor, G. L. et al. Temporal changes in breast milk fatty acids contents: a case study of malay breastfeeding women. Nutrients 13, 1–13, https://doi.org/10.3390/NU13010101 (2021).
doi: 10.3390/NU13010101
Reeve, L. E., Jorgensen, N. A. & DeLuca, H. F. Vitamin D compounds in cows’ milk. J. Nutr. 112, 667–672, https://doi.org/10.1093/jn/112.4.667 (1982).
doi: 10.1093/jn/112.4.667
pubmed: 6279806
Woltil, H. A., Van Beusekom, C. M., Schaafsma, A., Muskiet, F. A. J. & Okken, A. Long-chain polyunsaturated fatty acid status and early growth of low birth weight infants. Eur. J. Pediatr. 157, 146–52, https://doi.org/10.1007/s004310050787 (1998).
doi: 10.1007/s004310050787
pubmed: 9504790
Huang, P. et al. Effects of breast-feeding compared with formula-feeding on preterm infant body composition: a systematic review and meta-analysis. Br. J. Nutr. 116, 132–141, https://doi.org/10.1017/S0007114516001720 (2016).
doi: 10.1017/S0007114516001720
pubmed: 27181767
Quigley, M., Embleton, N. D. & McGuire, W. Formula versus donor breast milk for feeding preterm or low birth weight infants. Cochrane Database Syst. Rev. 7, CD002971, https://doi.org/10.1002/14651858.CD002971.PUB5/MEDIA/CDSR/CD002971/IMAGE_N/NCD002971-CMP-002-18.PNG (2019).
doi: 10.1002/14651858.CD002971.PUB5/MEDIA/CDSR/CD002971/IMAGE_N/NCD002971-CMP-002-18.PNG
pubmed: 31322731
Gale, C. et al. Effect of breastfeeding compared with formula feeding on infant body composition: a systematic review and meta-analysis. Am. J. Clin. Nutr. 95, 656–669, https://doi.org/10.3945/AJCN.111.027284 (2012).
doi: 10.3945/AJCN.111.027284
pubmed: 22301930
de Fluiter, K. S., van Beijsterveldt, I. A. L. P. & Hokken-Koelega, A. C. S. Association between fat mass in early life and later fat mass trajectories. JAMA Pediatr. 174, 1141–1148, https://doi.org/10.1001/jamapediatrics.2020.2673 (2020).
doi: 10.1001/jamapediatrics.2020.2673
pubmed: 32804197
pmcid: 7432277
Njokanma, O. F., Egri-Okwaji, M. T. C. & Babalola, J. O. Early postnatal growth of preterm low birth weight, appropriately-sized infants. Niger. J. Clin. Pr. 11, 104–110 (2008).
O’Connor, D. L. et al. Growth and development in preterm infants fed long-chain polyunsaturated fatty acids: a prospective, randomized controlled trial. Pediatrics 108, 359–371, https://doi.org/10.1542/peds.108.2.359 (2001).
doi: 10.1542/peds.108.2.359
pubmed: 11483801
Uijterschout, L. et al. Serum hepcidin in infants born after 32 to 37 wk of gestational age. Pediatr. Res 79, 608–613, https://doi.org/10.1038/pr.2015.258 (2016).
doi: 10.1038/pr.2015.258
pubmed: 26672736
Berglund, S. K., Lindberg, J., Westrup, B. & Domellof, M. Effects of iron supplementation and perinatal factors on fetal hemoglobin disappearance in LBW infants. Pediatr. Res. 76, 477–482 (2014).
doi: 10.1038/pr.2014.116
pubmed: 25119339
Van De Lagemaat, M., Amesz, E. M., Schaafsma, A. & Lafeber, H. N. Iron deficiency and anemia in iron-fortified formula and human milk-fed preterm infants until 6 months post-term. Eur. J. Nutr. 53, 1263–71, https://doi.org/10.1007/s00394-013-0629-0 (2014).
doi: 10.1007/s00394-013-0629-0
pubmed: 24292818
Stoltzfus, R. J. & Underwood, B. A. Breast-milk vitamin A status as an indicator of the vitamin A status of women and infants. Bull. World Health Organ 73, 703–711 (1995).
pubmed: 8846497
pmcid: 2486808